Loading...
HomeMy WebLinkAboutPermit Electrical 2003-5-6 bm' itted has the following ,as su , , d use at require specific Ian 7Qmn , 225 FIFTH STREET. SPRINGFIELD, OR 97477 · PH:(541)726-3753 · F~iJ~~ nV26-3689 ELECTRICAL PERMIT APPLICATION Zoning 1000 sq. ft. or less rtJ ,Each additional 500 sq. ft, or )/ f? ,4,7 r UJ1UJp Cdio. Cf!APft-oa:f portion thereof $ 19.00 cJ mm..L..D law e4ull8S yuu lu Permits are non-transferable and expire if work is Each ~wqfr4I.&QJJ.LW'(egon I on Utility not started within 180 days of issuance or if work is MOdJlrar.IQW1~~OO~6d by the Qreg $..eO\'Otif S d d ~ 180 d F d 01 ow Th SC ~"dA~ are s v . ~r' uspen e lor ays. ee I 'fication Center. 0 .' -2,.00', B. Electrical Contractor Ie. S EI/' /-1-/1 C ,~(tf)'lJJ{ -/k 200 AmflSlHmS. ~he cenoter. g(NoOn\~~i~~~ ~O~f~B~fj)~On 11fu.'1ffli fmJhe ra - - - O () !l... 't??3 201 Arlij> ~enfiris 1_800_~~?-?34.4$.75.00 Address . _ ,V..Jd)C tJ-'1TJ 401 Amps to 600JAmps $125.00 _ 601 Amps to 1000 Amps $163.00 City tu r~ Phone & p& -0',)",J.-' Over 1000 Amps/Volts $375.00 Reconnect Only $ 50.00 City Job Number Date 1. /33 fa -r ~QP~ LEGAL DESCRIPTION "Ii tl rl\ tfl()~f) r~3 U't'LW JOB DESCRIPTION 2. Expiration Date 3 V97S / (j ,Ii / [) C/ 7{)~~-7 J d-/:J()/~ 3 Supervisor License Number Constr. Contr. Number Expiration Date Signature of Supervising Electrician JJ/AkA: uJ ) Jt ! '~ / Owners Name ]3t'i!'f' L( LuLJJ P f~ ..-L.. Address I ~ 3 ''7'0 IYLCl /'Q~tL City g 6 {___i/J Phone 7,2~ - J 9b Y OWNER INSTALLA nON The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 ( f 11A/D (JV\. j~ S' 2-ocJ 3 ) ? ~ .A..fU! ell? cl ~ Date - l.;oft. !5-(, -0 '5 I , ~l re_ 3. A. Service Included $106.00 c. Installation, Alteration or Relocation D. New Alteration or Extension Per Panel One Circuit 1 Each Additional Circuit or with Service or Fee<;ler Permit $ 43.00 $ 3.00 E. Pump or irrigation Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial $ 50.00 $ 50.00 $ 25.00 $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4. 45. C() ?\5 4- ,s;i) C:;~.LO~ 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(T:)/Building FormslElectrical Permit Application I-03.doc City of Springfield Electrical Permit Attachment Status: Issued 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone 541-726-3676 Fax 541-726-3769 Inspection Line PERMIT NO.: ISSUED: APPLIED: EXPIRES: ELE2003-00117 5/5/2003 5/5/2003 11/5/2003 SITE ADDRESS: 1336 TAMARACK ST ASSESSOR'S PARCEL NO.: 1703273304200 PROJECT DESCRIPTION: Electrical for heat pump Springfield TYPE OF WORK: New TYPE OF USE: Residential ATTENTION:Oregon law re4Ulr~s you to follow n lies adooted bv the OreQon Utility ELEC1'Rll({jMti(m:SNPm\.€~R:ules are set fortl :Er ~~R 952-001-001 0 through OAR 952A001 ~~ ~~~~[3 You may obtain copies58h<W&-A1Ms b~ EUGENE O~~dl~e center. (Note: the telephone CCB # 708~~mb~~(l3~dff@~t~Pj>~otification - - ~ -..... \ \..Ierner I:::; '-/1\/1 '-,"'')'''.'''~'''.'. Date Paid Receiot Number OWNER/APPLICANT: BERRY LAWRENCE W & B A 1336 TAMARACK ST SPRINGFIELD OR 97477 Descriotion Amount Paid + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Minimum! Adjustment Electrical 4.50 3.15 43.00 2.00 05/05/2003 05/05/2003 05/05/2003 05/05/2003 2200200000000000805 2200200000000000805 2200200000000000805 2200200000000000805 To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following working day. Reauired Insuections: 'OQlH3d ^'VO 09 ~ ^NO~ S\ HO 03~N3WIN tJ 1 Rough Electric: Prior to Cover HO~ 03NoaN'Vg'V aNn 03ZIHOH1{)'tJ 2 Final Electric: When all electrical work is complete. lON S\ 1\INH3d S\Hl H31\.lUS 1\IN'd3d S\Hl M :1U' ~\ ~H\dX31 vn . 1\'\' nd By Signature, I state and agree, that I have carefully examined th~Q.plefeoappffcation and do hereby~et ifYffi'at all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the laws of the State of Oregon pertaining to the work described herein. I further certify that only contractors and employees who are in compliance with ORS 701.055 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street, and that the approved set of plans, if applicable, will remain on the site at all times during construction. Owner or Contractors Signature Date Page 1 of 1 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number ELE2003-00 117 ELE2003-00117 ELE2003-00 117 ELE2003-00 117 Payments: Type of Payment Check 5/5/2003 City of Springfidd Development Services Department Public Works Department ~ Official Receipt Receipt #: 2200200000000000805 Description Add, Alter, Extend Circ Minimum! Adjustment Electrical + 10% Administrative Fee + 7% State Surcharge Paid By KS ELECTRIC 8:50:08AM Received By ddk Date: 05/05/2003 Amount Paid Item Total: 43.00 2.00 4.50 3.15 $52.65 Check Number Confirm No How Received In Person Payment Total: Amount Paid 52.65 $52.65 Page I of 1 cReceipt.rpt